Postpartum Haemorrhage Initiative

Postpartum Haemorrhage (PPH) is the leading cause of maternal mortality in low-income countries.

The most common cause of PPH is poor contraction of the uterus (uterine atony).

Primary PPH is often defined as the loss of more than 500ml or 1,000ml of blood within the first 24 hours following childbirth. Secondary postpartum bleeding is that which occurs after the first day and up to six weeks after childbirth.  

Duration: 2010 - 2018

Funded through Gynuity Health Projects

Project Contact:  Rachel Gooden, Project Manager


Components of the Postpartum Haemorrhage Initiative

  • Developing materials for dissemination, including guidelines and protocols for professional societies and the global health community
  • Disseminating the latest evidence on interventions to prevent and treat PPH, including the effectiveness of misoprostol and other promising technologies
  • Organizing expert panel sessions at international, regional and national scientific obstetric and midwifery conferences
  • Commissioning articles related to misoprostol for PPH for publication in academic journals
  • Collecting country-level information, creating advocacy tools, and providing support on national advocacy efforts to reduce deaths and morbidities from PPH

What we have achieved so far

  • Developed international guidelines on prevention and treatment of PPH in low-resource settings
  • Produced international guidelines on prevention and treatment of PPH with Misoprostol
  • Successfully advocated for the inclusion of misoprostol for PPH treatment to be included on WHO’s 2015 Essential Medicines List, as well as earlier applications for the inclusion of misoprostol for postpartum haemorrhage prevention
  • Issued a joint statement with the International Confederation of Midwives (ICM) on misoprostol for the treatment of PPH in low- resource settings
  • Developed FIGO’s Misoprostol only recommended dosage chart (2012) when used alone for a variety of gynecologic and obstetric indications. Conducted a review of the latest evidence which led to updating of the chart (2017)
  • Conducted more than 40 expert panel sessions to disseminate the latest clinical information on PPH management
  • Launched a survey with our 130 member societies to find out more about the current status of country-level guidelines on PPH management

FIGO's member society survey

In 2016 FIGO conducted a survey of our member societies, to find out about their national guidelines for PPH, and inclusion of key PPH medicines on essential medicines lists (EMLs).

The aim of the survey was also to establish any challenges to implementing evidence-based practice, in order to further support FIGO Member Associations in working towards their maternal health goals.

Responses were received from 69 (53%) FIGO Member Associations, with the following findings:

  • 19% of respondents said that their country did not have national guidelines on PPH management
  • Of countries that do have national guidelines, 41% don’t include advice on misoprostol to prevent and treat PPH
  • 42 (61%) of respondents reported that misoprostol was listed on their national EML
  • 29% reported that misoprostol was not widely available
  • 28% reported a lack of supportive policy or programs for use of misoprostol

 Read the full results here.

Project materials